I have been looking around, mostly on pubmed ( https://www.ncbi.nlm.nih.gov/pubmed/ ), for non-chemotherapy strategies to reduce cancer recurrence and mortality. To avoid an overlong post, I will summarize very briefly the information I have found, with hopefully a link to one supporting study. If the topic interests you, I encourage you to go to pubmed and read more. Of course, all of this information is from my perspective only and you should use it as a springboard for discussion with your doctor or your own research.

Vitamin D: One of the most surprising results of my research was the impact of vitamin D on colorectal cancer recurrence and mortality. One article reports, “Freedman et al demonstrated in one of the largest prospective studies including 16,818 participants that CRC mortality was inversely related to serum 25(OH)D level. Individuals with serum levels of 50-80 ng/mL and > 80 ng/mL had a relative risk of CRC mortality of 0.44 and 0.28, respectively. ( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4419060/ ) That is a 72% reduction in colorectal cancer mortality for those with a serum 25(OH)D level of 80-100ng/mL!

The research on vitamin D levels is solid, but there are some indications that the vitamin D levels may be protective, rather than a form of treatment. Also, simply taking a vitamin D supplement may not be enough, there is some indication that the greatest benefit comes from exposure to the sun. That’s why jogging in your Speedo or bikini may be good for you!

Serum vitamin D levels apparently increase slowly, over weeks or months. On a personal basis, I had my vitamin D level tested and it was 29 ng/mL, surprising to me because I do a lot of outdoor activities in a sunny climate. My goal, needless to say, is to raise the level to more than 80 ng/mL. I have not started jogging in a Speedo yet, but I have stopped using sunscreen and I wear shorts and take my shirt off on my daily walks. Think of that, a potential 72% reduction in colorectal cancer mortality–way more than you get from Oxaliplatin–for the cost of some embarrassment, sunburn (and potentially an increased risk of skin cancer–but the colorectal cancer would probably get me before the skin cancer). See also: http://www.impactjournals.com/oncotarget/index.php?journal=oncotarget&page=article&op=view&path%5B%5D=16597&path%5B%5D=53092

Exercise: The second part of my title–go jogging in your Speedo, is exercise. For a high level of exercise (more than 9 hours per week) there’s a 23 to 63% increase in overall survival and more than 50% increase in CRC free survival, let’s just call it an easily justified 50%. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150459/ See also, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4922494/

Coffee: Have a cup of coffee, better yet four or more, before or after your jog in your Speedo. Solid research demonstrates that consuming 4 or more cups of coffee a day resulted in a 52% reduction in overall mortality. http://ascopubs.org/doi/pdf/10.1200/JCO.2015.61.5062

The Bone Zone: Along with vitamin D, described above, I found a cluster of supplements I generally relate to bone and joint health, have a cancer fighting component as well. Calcium and milk: A higher intake of calcium leads to reduced mortality by 38 to 41%. One study noted, “postdiagnosis total calcium intake was inversely associated with all-cause mortality (relative risk [RR] for those in the highest relative to the lowest quartiles, 0.72; 95% CI, 0.53-0.98; Ptrend = .02) and associated with marginally statistically significant reduced colorectal cancer-specific mortality (RR, 0.59; 95% CI, 0.33 to 1.05; Ptrend = .01). An inverse association with all-cause mortality was also observed for postdiagnosis milk intake (RR, 0.72; 95% CI, 0.55 to 0.94; Ptrend = .02), but not vitamin D intake.” In that study, calcium intake was over 1156 milligrams a day. So take a couple of calcium pills with a glass of milk (or a healthy dose of cream in your coffee) after your Speedo jog. http://ascopubs.org/doi/abs/10.1200/JCO.2014.55.3024?utm_medium=cpc&utm_campaign=J_Clin_Oncol_TrendMD_0&utm_source=TrendMDGlucosamine/Chondroitin/MSM: Another popular supplement usually associated with bones and joint pain is Glucosamine/Chondroitin/MSM. So far, the studies I have mentioned deal with the recurrence of colorectal cancer. Unfortunately, I could not find any that dealt with recurrence with these supplements, but there are studies dealing with the initial occurrence of colorectal cancer, plus what I call “test-tube” studies that were generally favorable. One study said, “Any use of glucosamine and chondroitin, which have anti-inflammatory properties, over the previous 10 years, was associated with significantly lower . . . CRC risk: HR: 0.73 (95% CI: 0.54, 0.98) and HR: 0.65 (95% CI: 0.45, 0.93), respectively. There were also statistically significantly inverse associations of fish oil: HR: 0.65 (95% CI: 0.42, 0.99), methylsulfonylmethane (MSM): HR: 0.46 (95% CI: 0.23, 0.93). . . with CRC risk. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2814533/ Let’s just guess that a combined Glucosamine/Chondroitin/MSM supplement could give you a 35% reduction in colorectal cancer.Aspirin: After your run in your Speedo, you might be feeling a bit sore and want an aspirin. Go ahead and take it. After initially promising research about aspirin, it seems its effect is limited to certain types of colorectal cancer. Early studies showed a 50%+ improvement, but a 2017 publication said, “In the three studies, median (maximum) follow-up was 5.1, 5.8 and 7.5 years, respectively. 3,033 incident CRC cases were identified in Study 1, 3,174 in Study 2, and 12,333 in Study 3. Current use of low-dose aspirin was associated with a significantly reduced risk of 34%, 29% and 31% in the three studies, respectively; corresponding RRs (95% CIs) were 0.66 (0.60-0.73), 0.71 (0.63-0.80) and 0.69 (0.64-0.74).” https://www.ncbi.nlm.nih.gov/pubmed/27428004 I have no in-depth information about my type of cancer, so I am taking a reduced dose aspirin daily, and a full dose aspirin on the many days I am sore (jogging in a Speedo takes some effort at my age), so let’s just say aspirin gives a 30% increase.Vitamin K: I do not know much about Vitamin K, but to my understanding it falls within the “bone zone,” supplements that are generally related to bone and joint health. The results about the influence of vitamin K on colorectal cancer are preliminary and mostly based on “test-tube” studies, but they are encouraging and I include a vitamin K supplement in my regime. http://www.reuters.com/article/us-vitamin-k-idUSTRE62U4VO20100331 http://ajcn.nutrition.org/content/91/5/1348.fullhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4449879/

Tree nuts: After your jog, you may also want to enjoy a handful of tree nuts. Eating two servings of tree nuts a week resulted in a 42% increase in disease free survival and a 57% increase in overall survival in a recent study. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4560032/

Multivitamins: Along with your lunch, why not take a multivitamin/mineral supplement. I found no reported studies on the impact of multivitamins on the recurrence of colorectal cancer, but I found support for about an 8% reduction in initial occurrence of colorectal cancer. It is probably worth it, just in case. https://www.ncbi.nlm.nih.gov/pubmed/25335850

Folate (Vitamin B9): Have some Brewer’s Yeast. At lunch time I drink KAL Brand Fortified Brewer’s Yeast Flakes. I admit, it is temporarily as miserable as having an Oxaliplatin infusion, but the horrible taste soon passes. This product is rich in many B vitamins and trace minerals including Folic Acid. Having a high level of serum Folate (Vitamin B9) is linked to a 25% reduced risk of recurrence of colorectal cancer ( http://journals.sagepub.com/doi/pdf/10.1177/0300060516650075 ) and a 50% reduction in initial occurrence of colorectal cancer ( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4981802/) A deficiency in folate is a special problem for people who drink alcohol, and low folic acid makes them particularly susceptible to colorectal cancer. ( http://jn.nutrition.org/content/133/11/3731S.full ) People who drink alcohol (that’s me) have an increased risk of a folic acid deficiency. If you are going to enjoy your evening glass of wine, some Brewer’s Yeast at lunch may help.

Diet: What you eat has impact on your risk of recurrence. Looking only at initial occurrence of colorectal cancer, a pesco-vegetarian diet (vegetarian diet plus fish) produces a 43% lower rate of cancer compared to a non-vegetarian diet. ( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4420687/ ) For colon cancer recurrence, a “Western diet” characterized by high intakes of meat, fat, refined grains, and dessert was 3.25 times more likely to lead to recurrence as opposed to a “prudent diet” characterized by high intakes of fruits and vegetables, poultry, and fish. ( http://jamanetwork.com/journals/jama/fullarticle/208423 ) I have adopted a pesco-vegetarian diet to optimize my odds.

Curcumin/Quercetin/Reservatol: There’s a packet of plant derived products that show great promise in both helping with chemotherapy and acting alone to attack cancer. The problem is that the research is very preliminary and deals mostly with test tubes and rats. Nonetheless, there is justification in considering supplementing your regime with these chemicals. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5386596/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3837545/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3836443/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5411934/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5104244/https://www.omicsonline.com/open-access/anticancer-activities-of-resveratrol-in-colorectal-cancer-0974-8369-1000317.php?aid=76773&view=mobile

Wine: After a long day of exercise and sun-tanning, you may be tired. Enjoy a vegetarian dinner made with Turmeric (curcumin) and then have a glass or two of wine. Although alcohol consumption may be related to the initial incidence of colorectal cancer, having one or two drinks a night (especially of red wine) is related to a lower recurrence of CRC, and in at least one 2017 article, an 11% better overall survival and disease free survival. http://abstracts.asco.org/199/AbstView_199_193741.html

Melatonin: Once you head to bed, consider some melatonin. One study says 20 mg. of melatonin reduces chemotherapy side effects and increases one year survival rate by 23.85% (general cancer, not colorectal specific). Melatonin is absorbed in the colon, an area that may have been compromised by surgery or cancer. Supplementing with melatonin seems promising, but has not yet been studied much. But it is part of my regime. https://www.ncbi.nlm.nih.gov/pubmed/22271210

Please let me know what supplements and strategies you have found to increase your odds. I have found that my doctors say nothing about these issues, yet there is solid evidence that lifestyle strategies and supplements can make a big difference in one’s chances of colorectal recurrence and mortality. This is my life we are talking about and I am very serious about learning all I can to stay alive. Let me know what you have learned.

Hi SandiaBuddy - Great read!!! Have been doing many of the above recos before I was dx with rectal cancer but that said continuing to do them after chemo. Have been a runner so just now getting back into it but have been walking continuously. Given chemo increases sunburn have been lathering the sunscreen as it is still in my system for a month. I am a 12+ year survivor of melanoma so also mindful of those risks. My Onc has encouraged vitamin D as well as running for overall exercise. Still managing the ileostomy so careful about core exercises due to risk of getting a hernia. He poo-poo'd glucosamine but I still take it for my joints. Great if it helps against recurrence! He also downplayed tree nuts/butter as it goes with a healthy lifestyle which overall improves survivability but I'm globbing almond and cashew butter on my english muffins. Enjoying third cup of coffee now so on that path! Just need to drink tons of water to counteract too much of it! Have been relaxing with 1-2 glasses of wine in the evening on off chemo weeks but since just learning NED (for now) enjoying a bit of champagne instead.

Thanks for shaing your links to various research papers. It's encouraging... now time to go running!

Cindy: Congratulations on the NED! It is great to hear that your strategies are working. I raise an (imaginary) glass of champagne to you!

Initially I did not have wine with chemo, but after reading about it, I see no harm--maybe someone will enlighten me. If the wine opens up the small capillaries and carries the chemo further, wouldn't it be beneficial? I know the medical community is awfully conservative about alcohol, so the advice is generally against it, but what is the basis of that advice?

Thank you so much for taking the time to condence this information and for sharing it with us! When I was at the cancer weekend in the fall they were really extolling the virtues of exercise, too. I think I'm going to try the Brewer's yeast but I'm going to take a capsule. I just can't do some kind of yucky drink. I'm a gagger. I have a hard time drinking plain water. For some reason it tastes like wet rocks to me. But I have to drink a big glass of it once a week to take my pill for my parathyroid. Your list really gives us something to think about!

Well I'm hitting about 95% of all those things, starting with a couple cups of coffee in the morning. I was doing the multivitamin, baby aspirin, simvastatin, melatonin, beer every third day or so, I work outside most of the time in sunny SoCal, and it's physical stuff, with using an eliptical on the side for cardio. These were things I was doing at or just after diagnosis back in Sep. 2007, and I still had two reoccurances in my liver, so they don't guarantee anything, but maybe my cancer would have spread to a much greater degree had I not been doing them. I improved my diet with more fruit and veggies, less dairy[but I still love cheese on things]. Recently I've added the chondroitin/glucosamine for joints, milk thistle for liver health, almonds and walnuts for snacks. The multivitamin has 100% of daily folate required, along with whatever green veggie I'm having so I think I'm covered there. I read that one study suggested too much folate had risks as well, so I don't supplement more than what I'm already taking. Same with vitamin K which has a DV percentage of 38% in the vitamin and is present in the green leafy stuff. So I am following almost all the stuff on your list and am closing in on 3 years NED. The other point to note is I had one tumor in my sigmoid section, and haven't had a single polyp since, so perhaps the regimen helped there. I aim for fish and chicken with an occasional spurge of a cheeseburger or steak. So there you have my program, which I feel pretty good about, without feeling deprived of life's good stuff........................................Dave

hi beaumontdave, My husband was very active and had a healthy lifestyle before his stage IV CRC dx too. he was so upset wondering what he could have done to prevent it...but I told him the same thing: it may have been much worse if he hadn't been so careful before. He has really bounced back well from his surgeries too which I contribute to him taking such good care himself.

Not his fault at all. Unless it runs in your family, it's a fairly random cancer to get. The odds go up from being overweight, smoking, and very heavy drinking, and from what you tell me, he was not in those catagories. They say our diet puts us at more risk then say the Japanese' average diet, but a lot of what they're learning about this stuff is just coming out. No one was talking about colon cancer causes when I was younger, and even still, it's fairly random who gets it. My pop ate as he pleased all his life, so did most folks around me as I grew up, and they lived long, happy lives. My dad getting CRC at 80[stage 2] was what prompted me to get checked[along with some random rectal bleeding]. Then I found out his younger sister died from it at 76. So it runs in the family, but no one was talking about it until I got it. I tell everyone who's related, and anyone nearing 50 that they need to get the scope and not put it off, because the family not talking about it may have contributed to mine, since I was thinking I didn't need the scope until I hit 50. I was diagnosed at 49+. Like you say, your man's healthy lifestyle likely keep his cancer from being worse sooner, and will help him beat it back. Life is full of "lotteries" and in this one, his [and all here] number just came up. Bad luck, but that's all it is, and how we deal with it from here on, is what counts. Good luck to you both, from here on out....................Dave

I have a friend who has been a vegetarian for over 30 years and she also tried very hard to be Vegan. She's had cancer. And I've mentioned before about our friend's horse that had a huge colon tumour. He never ate meat, I can guarantee that. So I really don't put much stock in the diet part other than to not eat a bunch of crap or processed stuff.

My doctor also told me that it wasn't anything that was my fault with food, exercise, drinks, or meats. I've always been active my whole life and always had salad as my main meal so I'm never a believer that diet has anything to do with it. It always came to mind when watching a St. Jude Hospital commerical and seeing those little babies dealing with cancer - they never were old enough to consume the things that people claim gave you cancer.

Kim, I am in complete agreement that looking back is of no purpose, unless it helps you to change behaviors that may have put you at risk for cancer. I also understand that each of us has our own approach to this issue. This is a rather old post that has resurfaced, and at the time I was not so careful to couch my terms to limit the application solely to me. I hope I am doing better at that now. I came accross this study last night, but chose not to post anything about it, since the survival statistics are so abysmal, but it certainly does support the premise that diet can help limit the chances of recurrence, so it may be worth a look.

And BTW I'm not going to exercise in my bikini either LOL. Actually just bought a bathing suit this year for the first time in 25 years. I'm just not a water person but we were staying at a place that had a pool and thought my old Speedo might be outdated LOL. Thanks again for all your info and love it when you break it down.

My D levels were low until I started taking high doses of D3. Sun exposure doesn't help me. Of note, my sisters also have low D-levels. One is a farmer, always out in the sun, the other lives in Hawaii - always out in the sun. Thus I think that we have a familial tendency towards low D levels. We all have to take supplements to normalize D levels. (Oh, and the prescription D2 of 50,000 units once or twice a week does nothing for me either. I require D3, and take 10,000iu/day under my dr's supervision.)

It's good to see all these great resources summarized in one post! I have taken some of these supplements, and will work towards the exercise in the sun. My Vitamin D levels are low, and have been taking supplements but probably need to switch to a different form. Low vitamin D levels have been linked to several health problems, including dementia.

All it does it gets me weird looks or psych evaluations. May switch to a Speedo next time :)

My oncologists mentioned many of the things, with the big ones being the aspriin and exercise as the most bang for the buck. Meaning they said many things can help with improvements, but make sure to take the aspirin and exercise. They also cautioned about adding supplements during chemo and even after - for the former due to counteracting chemo and the later to overdoing any good thing it too much.

Coffee is a food group for me so when I read about that awhile ago I was happy :) My PCP is always big on vitamin D also and checks me for that even before this all happened. You could tell for sure what time of the year it was (or whether I spend substantial time away in sunny places scuba diving) based on the results.

Another reason for people who smoke to give it up - it adversely affects Vitamin D

Would aspirin still be recommended for anyone having chemo + avastin? Avastin causes me to have bleeding gums, nose bleeds/scabbing, and I believe bloody phlegm. I think it may even cause clotting issues.

Aspirin effects are not totally understood yet, I've read. It doesn't directly thin blood like other compounds, they say it makes blood "slippery" The wife took Avastin and nothing was said about aspirin at the time. Being it's main job is to cut off blood supply to tumors, I don't believe Avastin is the culprit with your side effects. Either way, I'd skip aspirin until your clear of chemo. Studies say aspirin has to be taken over a long period for anti-cancer properties to be realized, maybe 5 years or more................................................................................Dave

Aspirin helps impair platelets (clots) from forming by preventing them from clumping (essentially slippery, a great description), while other things (heparin) slow the bodies reaction of doing things that result in clots forming. The drugs are all kind of similar/related.

In heart attack situations what happens is the plaque from fats build up. When the plaque tears off, the body thinks it is a wound and tries to seal it off by forming platelets. When the platelets form a big enough clump, blood cannot pass through. Making the platelets slippery helps stop a clot from forming. For a bit So if you ever have signs or symptoms of heart attack, call 911 and chew an aspirin in most cases. People should speak to their Doc about that. In some cases such as stomach bleeding history or allergic reactions, it may not be the proper move. And people should chew the aspirin. While some aspirin is uncoated, many are designed with coatings to slow down release in the stomach. You want it to get into your system as quick as possible. Needs to be aspirin, not Tylenol or Advil.

As to cancer side, you got me, no idea why it works as anti cancer drug I am not sure if I started aspirin during chemo or waited until after, but chemo would seem to trump the anti-cancer potential of aspirin and definate call from oncologist if bleeding issues. Kind of a bummer about the 5 year build up time on aspirin. I wonder if I take a bottle a day it would build up quicker (joking of course)

EDIT: Not sure what is what happening with the weird emojis. Used standards ones and they look standard when typing, when posted they looked weird.

EDIT 2: After posting first edit, they changed. They are now cat images if you blow them up. Too funny

I just saw a new oncologist and he brought up the bleeding issue and said I should not take aspirin during the chemo. When I told him I already did, he said obviously bleeding was not an issue, so I could continue. But with your issues, it sure sounds like it would not be a good idea. Of course, the oncologist would be the source of the best advice.

SandiaBuddy for another great post. Are you taking all these supplements while on chemo or waiting till you're finished? I just started round one of four mop up chemo flofiri and avastin. After I'm finished with these I think I'll start with some of the supplements. I've been on vit d for years, drink coffee, and love me some wine. I've been an active person but certainly can stand to boost that up. I must say the thought of me running in a bikini?...in public???....that just makes death not so scary!lol

Well, I actually do not run in a speedo. Actually, I do not run. But on sunny days I wear shorts and take off my shirt in the open space areas (but not in the neighborhood). I am on capecitabine and I am taking all the supplements. It seems they have helped take some of the edge off the chemo. Some people have voiced concerns about the antioxidants protecting the cancer cells and I do know there is some research on this particulalry anti-oxidant vitamins. One of the stregnths of the curcumin/reservatol/grape seed extract group is that they are supposed to actually make the chemotherapy more effective. For example, "Curcumin is nontoxic in nature and has been proposed to increase the therapeutic efficiency of chemotherapeutics as it inhibits ABC transporter function and increases the oral bioavailability of chemotherapeutics.11 Curcumin is being used as an antioxidant since the ancient times.8,12 Recently it has been shown that curcumin inhibits tumor growth by inhibiting cell cycle progression or by inducing apoptosis; by inhibiting angiogenesis, the expression of antiapoptotic proteins, multiple cell survival signaling pathways and their cross-communication; and by modulating immune responses.7,13,14 Curcumin induces the initiation of both p53-dependent and p53-independent G2/M phase cell cycle arrest,13,15–17 thereby restricting cell proliferation and tumor progression." https://www.ncbi.nlm.nih.gov/pubmed/28435333

I have not gone back and added the grape seed extract, so I will just post some information on that here pending my getting time to edit the original post:

My hubby can run around in his speedo anytime! (He's a bit self conscious of his surgery scars, but I told him he looked like he had been in a sword fight like a pirate and he liked that. ;) ) Took notes on all the supplements too. I know we have to be careful with acetimephine (sp)/ tylenol because of his liver mets and previous hepatic lobectomy. I wonder if aspirin can cause a problem too. He won't touch a drop of alchohol with the liver problem either. But just an FYI, he has been taking over the counter prenatal vitamins and they have really helped his energy....and given him great nails and hair which doesn't hurt with chemo. (His nails look better than mine!) They have more types of iron, folate and B vitaimins than the standard multi vitamin and it made a difference for him in a day. They also have the extra calcium. Probiotic gummies vitaimins help him bounce back after all the anitibiodics from the ostomy reversal. He still takes those daily and it has slowed the number of trips to the restroom for him. Coffee is his joy, so he will love to hear that. I wonder if the caffeine has a similar effect on capillaries? Thanks so much for the great research and sharing!

Thanks, OTR. The information is a bit dated. One of these days I will revise it all, but I am just so darned busy all the time! There will be no research for a while, my modem died so I am confined to using a cell phone and paying for data, then I have a trip coming up, but I will be back to nightly research soon.

I take a variety of brands. I try to look for ones manufactured in the US or Canada, but that is not always possible. I have found that Swansons has a good variety of brands for reasonable prices--although on their self-branded products, the country of origin is unclear.

I have ordered many things from Swansons and have always gotten good quality products from them. It's great to find something that isn't so caustic or hard on your body that actually makes a difference or helps you get thru side effects. The only way we are going to know these things is if we share them. Thanks for sharing...you do your homework, lol. Hugs, M

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